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Why is it important to know if a doctor or medical facility is

"in-network"?
It tells you if they are able to accept new patients.
It allows you to know if they are certified to practice medicine in
your location.
Your health insurance plan will pay less for their services after
your deductible is met.
Your health insurance plan will pay a greater percentage of their
costs after your deductible is met.

1 Answer

6 votes

Step-by-step explanation:

The Importance of Staying In-Network

Make sure you use doctors and service providers that are in-network:

It will significantly reduce your out-of-pocket medical expenses, and

Ensure any costs you incur are applied towards your plan's deductible and out-of-pocket maximum (out-of-network costs don't count).

Ask "Is this in my network?"

When making an appointment or scheduling a procedure, the most common question patients ask is "Do you take my insurance?" While many doctors and hospitals will accept your insurance, it doesn't mean they are in your network. And going out-of-network is expensive.

Instead, ask "Is this in my network?" And, if you're in the ER or hospital, be sure to write "only use in-network care" on all paperwork you sign.

As the insurance policy holder, it's your responsibility to make sure you only use in-network providers and facilities. So you should always verify in-network coverage.

What if my doctor/provider isn't covered?

For many, determining whether your primary care physician and health care providers are in-network is a key factor in selecting a plan. Ideally, your preferred doctor and preferred health plan line up.

Sometimes a tough decision has to be made: Do I go with my preferred plan (and find a new doctor) or select a more expensive plan that covers my doctor?

Only you can determine what will best serve you and your family in this situation. Are you financially able to take on higher costs? Will there be discontinuity in care?

Did you know...? Even if you choose the plan that covers your doctor, it's not unusual for doctors to enter or decide to leave a health insurance network.

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